经棘突椎板截骨原位椎管成形术

摘要

Objective： To reconstruct the posterior structre of the spinal canal after laminectomy and prevent instability and the scar tissue adherent to dura and nerve root. Method： The procedures contain the osteotomy through spinous process and lamina, and taking off the amputated posterior structure of the spine，after treating the pathologic change in intraspinal canal，the posterior structure is reduced and fixated with the wire．Result： 556 cases have been treated with this method since June l992．From 6 months to 5 years，264 cases follow up．The results were satisfactory．Conclusion： The method is suitable for the spinal stenosis, protrusion of intervertebral disc and intraspinal tumor. The spinal canal can be expored enough．The posterior structure of spine can be anatomiclly reconstrtucted. Therefore the stability of spine can be keeped．It can prevent the scar tissue adherent to dura and nerveroot．%目的：椎板切除术后重建椎管后部结构，保持脊柱稳定预防疤痕粘连压迫硬膜及神经根。方法：采用经棘突椎板截骨将椎管后部结构整块取下，处理完椎管内病变后再将后部结构原位回植固定。结果：1992年6月以来，用这种方法治疗胸腰段椎管内疾患556例，其中随访半年以上的264例，取得了满意的效果。结论：这种方法能够充分显露椎管，保留椎管的解剖结构，术后能保持脊柱的稳定性，防止疤痕粘连压迫硬膜及神经根，是一种接近于解剖性重建的成形术。